Unnatural deaths in South African platinum miners, 1992-2008

Exploring Occupational Health and Safety Standards Compliance in the South African Mining Industry, Limpopo Province, Using Principal Component Analysis

The health and safety of the miners in the South African mining industry are guided by the regulations and standards applied to promote a healthy work environment. The miners must comply with these regulations/standards to protect themselves from potential occupational health and safety risks, accidents, and fatalities. The status of compliance to safety regulations and standards in the mining industry of Limpopo Province has received little attention from scholars. This study explores the practices related to occupational health and safety standards compliance in the mining industry. A total of 277 miners were randomly selected from 1300 respondents in the mining industry. Data were collected using a 31-item survey questionnaire, administered to miners to explore occupational health and safety standards compliance from December 2019 to May 2020. Principal Component Analysis (PCA) extracted key attributes of occupational health and safety standards compliance in the mining industry and uncovered relationships between different dimensions. The study revealed that seven factors could measure occupational health and safety standards practices. It was observed that Factor 1 (occupational health practice related to regulations) is correlated with Factor 2 (measures to reduce risk of injuries/accidents). Additionally, Factor 2 (measures to minimise the risk of injuries/accidents) is correlated with Factor 4 (impact of the environment and production). There is a correlation between non-compliance with the safety regulations and the occurrence of injuries and accidents.

Estimating the mortality burden of large scale mining projects-Evidence from a prospective mortality surveillance study in Tanzania

We set up a mortality surveillance system around two of the largest gold mines in Tanzania between February 2019 and February 2020 to estimate the mortality impact of gold mines. Death circumstances were collected using a standardized verbal autopsy tool, and causes of death were assigned using the InSilicoVA algorithm. We compared cause-specific mortality fractions in mining communities with other subnational data as well as national estimates. Within mining communities, we estimated mortality risks of mining workers relative to other not working at mines. At the population level, mining communities had higher road-traffic injuries (RTI) (risk difference (RD): 3.1%, Confidence Interval (CI): 0.4%, 5.9%) and non-HIV infectious disease mortality (RD: 5.6%, CI: 0.8%, 10.3%), but lower burden of HIV mortality (RD: -5.9%, CI: -10.2%, -1.6%). Relative to non-miners living in the same communities, mining workers had over twice the mortality risk (relative risk (RR): 2.09, CI: 1.57, 2.79), with particularly large increases for death due to RTIs (RR: 14.26, CI: 4.95, 41.10) and other injuries (RR:10.10, CI: 3.40, 30.02). Our results shows that gold mines continue to be associated with a large mortality burden despite major efforts to ensure the safety in mining communities. Given that most of the additional mortality risk appears to be related to injuries programs targeting these specific risks seem most desirable.

Excess Mortality Due to External Causes in Women in the South African Mining Industry: 2013-2015

Mining is a recognized high-risk industry with a relatively high occurrence of occupational injuries and disease. In this study, we looked at the differences in mortality between male and female miners in South Africa. Data from Statistics South Africa regarding occupation and cause of death in the combined years 2013–2015 were analyzed. Proportional mortality ratios (PMRs) were calculated to investigate excess mortality due to external causes of death by sex in miners and in manufacturing laborers. Results: Women miners died at a significantly younger age on average (44 years) than all women (60 years), women manufacturers (53 years), and male miners (55 yrs). There was a significantly increased proportion of deaths due to external causes in women miners (12.4%) compared to all women (4.8%) and women manufacturers (4.6%). Significantly increased PMRs were seen in car occupant accidents (467, 95% confidence interval (CI) 151–1447), firearm discharge (464, 95% CI 220–974), and contact with blunt objects (2220 95% CI 833–5915). Conclusion: This descriptive study showed excess deaths in women miners due to external causes. Road accidents, firearm discharge, and contact with blunt objects PMRs were significantly increased. Further research is required to confirm the underlying reasons for external causes of death and to develop recommendations to protect women miners.

Socio-demographic contributors to health and safety of mine workers in South Africa

BACKGROUND

Mine workers in South Africa face various health and safety risks, and socioeconomic challenges.

OBJECTIVE

This study aimed to assess the associations between socio-demographic factors and health, safety and wellness in the South African mining industry.

METHODS

Qualitative and quantitative data were collected from 64 interviews with mine management and labour representatives, 14 focus groups with mine workers, and 875 questionnaires completed by mine workers from three platinum, two gold, one coal, one diamond, and one manganese mine in South Africa.

RESULTS

Health challenges included non-communicable diseases, HIV/AIDS, tuberculosis (TB), and respiratory diseases, while safety challenges included worker behaviour, stress and fatigue. Socio-demographic factors associated with disease, sick leave, fatigue, accidents and job satisfaction included age, length of service, race, nationality, education, mining sector, work status, income, housing, domestic crowding, sleep, exercise, alcohol use, and perceived quality of life.

CONCLUSION

Socio-demographic factors should be taken into consideration when developing workplace health and safety programmes.

Introduction: 'dying for gold': the effects of mineral miningon HIV, tuberculosis, silicosis, and occupational diseases in southern Africa

Mineral mining is among the world's most hazardous occupations. It is especially dangerous in southern Africa, where mining activity is a leading cause of HIV and tuberculosis epidemics. Inside mines, silica dust exposure causes long-term pulmonary damage. Living conditions are often substandard; poorly ventilated living quarters facilitate tuberculosis and airborne disease spread, and high rates of alcohol and tobacco use compromise immune responses. Family segregation, a legacy of apartheid's migrational labor system, increases the likelihood of risky sexual activity. Sex trafficking in women increases risks of HIV and other sexually transmitted diseases, and labor trafficking in men through poorly regulated labor brokering impedes access to health care. Labor migration spreads mining hazards to rural, labor-supplying communities. Cross-border care is often inadequate or nonexistent, contributing to significantly greater rates of extensive and multi-drug resistance in miners, ex-miners, their families, and communities. Miners in high-income countries, working for the same transnational companies, do not experience elevated rates of death and disability. Cost-effective interventions can reduce HIV incidence through social housing, curb trafficking of high-risk groups, stop tuberculosis spread through screening and detection, and reduce drug resistance by standardizing cross-border care. Urgent action is needed to respond to mining's staggering, yet avoidable disease toll in sub-Saharan Africa.

The impact of HIV, an antiretroviral programme and tuberculosis on mortality in South African platinum miners, 1992-2010

Background

HIV and tuberculosis (TB) are the most common causes of death in South Africa. Antiretroviral therapy (ART) programmes should have had an impact on mortality rates. This study describes the impact of HIV, a Wellness (HIV/ART) programme and TB on population-wide trends in mortality and causes of death among South African platinum miners, from before the HIV epidemic into the ART era.

Methodology/Principal Findings

Retrospective analysis was conducted using routinely-collected data from an open cohort. Mortality and causes of death were determined from multiple sources, including cardiorespiratory autopsy records. All-cause and cause-specific mortality rates were calculated by calendar year. 41,665 male miners were observed for 311,938 person years (py) with 3863 deaths. The all-cause age-standardised mortality rate increased from 5.9/1000py in 1992 to 20.2/1000py in 2002. Following ART rollout in 2003, annual mortality rates fluctuated between 12.4/1000py and 19.3/1000py in the subsequent 7 years. Half of all deaths were HIV-related and 21% were caused by TB. Half (50%) of miners who died of HIV after ART rollout had never been registered on the Wellness programme. TB was the most common cause of death in HIV positive miners, increasing from 28% of deaths in the pre-ART period to 41% in the post-ART period.

Conclusions/Significance

This population-based cohort experienced a rapid increase in mortality from 1996 to 2003 due to increases in HIV and TB mortality. Following ART rollout there was a decrease in mortality, but a steady decrease has not been sustained. Possible explanations for these trends include the changing composition of the workforce, maturation of the HIV epidemic, insufficient uptake of ART and an increase in the proportion of deaths due to TB. In order to make a significant and sustained reduction in mortality in this population, expanding and integrating HIV and TB care and treatment is essential.